ATI RN
ATI Fluid Electrolyte and Acid-Base Regulation
1. A patient who is being treated for pneumonia starts complaining of sudden shortness of breath. An arterial blood gas (ABG) is drawn. The ABG has the following values: pH 7.21, PaCO2 64 mm Hg, HCO3 = 24 mm Hg. What does the ABG reflect?
- A. Respiratory acidosis
 - B. Metabolic alkalosis
 - C. Respiratory alkalosis
 - D. Metabolic acidosis
 
Correct answer: A
Rationale:
2. You are caring for a patient admitted with a diagnosis of acute kidney injury. When you review your patients most recent laboratory reports, you note that the patients magnesium levels are high. You should prioritize assessment for which of the followin
- A. Diminished deep tendon reflexes
 - B. Tachycardia
 - C. Cool, clammy skin
 - D. Acute flank pain
 
Correct answer: A
Rationale:
3. A patient admitted with a gastrointestinal bleed and anemia is receiving a blood transfusion. Based on the patient's hypotensive blood pressure, the nurse anticipates an order for IV fluids from the physician. Which of the following IV solutions may be administered with blood products?
- A. D5 and 0.45% Normal Saline
 - B. Lactated Ringer's
 - C. 5% dextrose in water
 - D. 0.9% NaCl
 
Correct answer: D
Rationale: The correct answer is D: 0.9% NaCl. The only IV solution that can be administered with blood products is normal saline (0.9% NaCl). This solution is compatible with most blood products and is commonly used during transfusions to maintain hemodynamic stability. Choices A, B, and C are incorrect. Choice A, D5 and 0.45% Normal Saline, contains dextrose and is not recommended to be given simultaneously with blood products. Choice B, Lactated Ringer's, contains calcium, which can cause coagulation and should not be mixed with blood. Choice C, 5% dextrose in water, is hypotonic and not suitable to be administered with blood products.
4. While assessing clients on a medical-surgical unit, which client is at risk for hypokalemia?
- A. Client with pancreatitis who has continuous nasogastric suctioning
 - B. Client who is prescribed an angiotensin-converting enzyme (ACE) inhibitor
 - C. Client in a motor vehicle crash who is receiving 6 units of packed red blood cells
 - D. Client with uncontrolled diabetes and a serum pH level of 7.33
 
Correct answer: A
Rationale: Continuous nasogastric suctioning can lead to hypokalemia due to the loss of gastric contents rich in potassium. Therefore, a client with pancreatitis who has continuous nasogastric suctioning is at risk for hypokalemia. Option B is incorrect because ACE inhibitors may lead to hyperkalemia, not hypokalemia. Option C is incorrect as receiving packed red blood cells can lead to hyperkalemia due to the potassium content in the blood product. Option D is incorrect because a serum pH level of 7.33 indicates acidosis, which is not directly associated with hypokalemia.
5. When does dehydration begin to occur?
- A. the body reduces fluid output to zero.
 - B. the body increases the release of ANH.
 - C. the salivary secretions decrease.
 - D. the salivary secretions increase.
 
Correct answer: C
Rationale: Dehydration leads to a decrease in the body's fluid levels, causing the salivary glands to produce less saliva, resulting in a dry mouth. Therefore, when dehydration begins to occur, salivary secretions decrease. Choice A is incorrect because the body does not reduce fluid output to zero during dehydration; it tries to conserve fluids. Choice B is incorrect as dehydration does not directly increase the release of ANH (Atrial Natriuretic Hormone). Choice D is incorrect because salivary secretions do not increase but decrease during dehydration.
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